Alternatives to Suicide Peer-to-Peer Groups These groups have been nurtured and developed within the Western Mass Recovery Learning Community (RLC). www.westernmassrlc.org

Examining our beliefs about suicide

I believe suicide is okay in some situations, like when someone is terminally ill.

I believe that people should be stopped from killing themselves by any means necessary.

I believe certain thoughts and feelings are always a predictor for suicide.

I believe that people who kill themselves are selfish.

What do we bring to the table? What did this exercise bring up for you? What did you learn regarding your own beliefs? How might these beliefs impact your ability to talk openly about suicide?

Values Self-help with focus on relationship Mutual respect, support, and empathy Non-clinical and non-coercive Instead of one expert, everyone is the expert of their own experience Respectful of each person’s privacy Maintain transparency; share any limits to privacy

Framework Mutual support group and not a clinical group or treatment program People join for as long as it suits them No ‘red tape’ or ‘hoops’ for anyone attending (e.g., no assessment, intake, or discharge) Facilitators openly identify with the experience of suicidal thoughts No documentation or records kept (beyond total numbers)

The Gist People share from their own experiences Ordinary, non-medical language is used Curiosity-based vs. fear-based responses Value of meeting and accepting people as they are Willingness to sit with deep distress; not jumping to clinical interventions

Freedom Attendance is completely voluntary and self-determined Freedom to interpret experiences in any way Freedom to challenge social norms Freedom to talk about anything; not just thoughts of suicide

Out of the Box No assumption of illness No assumption that suicidal thoughts are connected to mental illness Differences between suicide and self- injury are acknowledged and respected

Practical Matters Group meets in the community, not in a clinical setting Group open to people not using services Group open to people from other geographical areas No clinical pressure on facilitator to report back to anyone else

The charter and guide to groups Alternatives to Suicide Groups: mutual support groups around extreme despair and suicidal feelings Alternative Conversations Groups: adapted from Alternatives to Suicide values for provider settings that limit fuller groups

PROCESS FOR STARTING/HOLDING THE GROUP

Alt to Sui Values for non-peer providers Partnership Role to avoid: Risk assessor, protector, decider, etc. Transparency Role to avoid: Secretly calling for help, keeping the individual in distress ‘busy’ while someone else calls for help, pretending you are not affected by their distress, etc. Continuity Role to avoid: Seeing the individual as ‘taken care of’ or ‘no longer your problem’ once referred elsewhere Partnership: The support person(s) will regard their role as that of a partner in identifying concerns and potential options. (Role to avoid: Risk assessor, protector, decider, etc.) Transparency: The support person(s) will be honest about his or her own concerns and need for support in difficult situations, including when they feel they need to call a supervisor or colleague during a given interaction. (Role to avoid: Secretly calling for help, keeping the individual in distress ‘busy’ while someone else calls for help, pretending you are not affected by their distress, etc.) Continuity: The support person(s) will be aware of their own limitations in time and availability, but will seek a way to maintain a connection with the person they are supporting, even if that individual chooses to go to the hospital, etc. (Role to avoid: Seeing the individual as ‘taken care or’ or ‘no longer their problem’ once referred elsewhere.)

Possible Questions/ Helpful Statements What’s going on? Did something happen that triggered you feeling this way? Have you felt this way before? How can I help?

Possible Strategies/Interventions Reflect and validate. Develop a plan that includes concrete steps to check in later that day and the next day, and resources to get through the next 24 hours. If in person, offer to go for a walk with the individual. Offer to call emergency services with the individual. Reflect (“It sounds like your…”) and validate (“After everything you’ve been through, it makes total sense to me that you’d be feeling this way.”

Q & A

Val Neff val@namifoxvalley.org (847)337-5343 Contact Us Val Neff val@namifoxvalley.org (847)337-5343 Funding for this conference was made possible by NITT-HT grant, CFDA 93.243 from SAMHSA.  The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.